Is Vigorous Exercise Training Superior to Moderate for CVD Risk after Menopause?

Physical activity and 4-year changes in body weight in 52,498 non-obese people: the Lifelines cohort

OBJECTIVES

We investigated associations between leisure-time physical activity (LTPA) at different intensities (moderate and vigorous or moderate-to-vigorous) and prospective weight gain in non-obese people. We also examined whether these associations were independent of other lifestyle factors and changes in muscle mass and whether they were age-dependent and changed over a person's life course.

METHODS

The data were extracted from the Lifelines cohort study (N = 52,498; 43.5% men) and excluded obese individuals (BMI > 30 kg/m2). We used the validated SQUASH questionnaire to estimate moderate-to-vigorous (MVPA; MET≥4), moderate (MPA; MET between 4 and 6.5) and vigorous PA (VPA; MET≥6.5). Body weight was objectively measured, and changes were standardized to a 4-year period. Separate analyses, adjusted for age, educational level, diet, smoking, alcohol consumption and changes in creatinine excretion (a marker of muscle mass), were performed for men and women.

RESULTS

The average weight gain was + 0.45 ± 0.03 kg in women. Relative to each reference groups (No-MVPA, No-MPA and No-VPA), MVPA (Beta (95%CI): - 0.34 kg (- 0.56;-0.13)), MPA (- 0.32 kg (- 0.54;-0.10)) and VPA (- 0.30 kg (- 0.43;-0.18)) were associated with less gain in body weight in women after adjusting for potential confounders, described above. These associations were dose-dependent when physically active individuals were divided in tertiles. Beta-coefficients (95%CI) for the lowest, middle, and highest MVPA tertiles relative to the 'No-MVPA' were, respectively, - 0.24 (- 0.47;-0.02), - 0.31 (- 0.53;-0.08), and - 0.38 (- 0.61;-0.16) kg. The average weight gain in men was + 0.13 ± 0.03 kg, and only VPA, not MPA was associated with less body weight gain. Beta-coefficients (95%CI) for the VPA tertiles relative to the 'No-VPA' group were, respectively, - 0.25 (- 0.42;-0.09), - 0.19 (- 0.38;-0.01) and - 0.20 (- 0.38;-0.02) kg. However, after adjusting for potential confounders, the association was no longer significant in men. The potential benefits of leisure-time PA were age-stratified and mainly observed in younger adults (men < 35 years) or stronger with younger age (women < 55 years).

CONCLUSION

Higher leisure-time MVPA, MPA, and VPA were associated with less weight gain in women < 55 years. In younger men (< 35 years), only VPA was associated with less weight gain.

Comparison of Linear and Nonlinear HRV Dynamics Across Exercise Intensities After Menopause

The authors compared the linear and nonlinear heart rate variability dynamics from rest through maximal exercise in postmenopausal women who trained at either moderate or high intensities. The outcome variables included the RR triangular index, TINN, SD1, SD2, SD1/SD2, DFA α1, DFA α2, and α1/α2. Maximal exercise reduced SD1, SD2, DFA α1, DFA α2, α1/α2, RRTri, and TINN in both groups and increased SD1/SD2 (p < .05). Two minutes of active recovery produced significant increases in SD1, SD2, DFA α1, and TINN, compared with exercise in both groups (p < .0001). There was also a significant main effect between groups for RRTri during exercise recovery, with the moderate group achieving higher levels (p < .04). The authors have shown that both moderate and vigorous exercise training can lead to a healthy response to maximal exercise and recovery, with the moderate group having a slightly improved recovery in the triangular index.

Assessment of HRV after maximal exercise in trained postmenopausal women

Increased parasympathetic tone achieved with endurance training may provide cardioprotection after menopause. To compare heart rate variability (HRV) from rest through maximal exercise and recovery in trained postmenopausal women. Thirty-six postmenopausal women who self-reported training at either moderate (MOD; 3-5.9 METS; 58.9+/-4.4 year) or vigorous (VIG; >6 METS; 59.7+/-5.2 year) intensities participated. HRV was measured for 5 min in the supine position, in the last minute of the VO2max test and after 2 min of active recovery. HRV in MOD and VIG was compared using a factorial ANOVA with repeated measures on time. MOD and VIG responded similarly over the three time periods for root mean square of sequential deviations (rMSSD), and high (HF) and low frequency (LF) power (p>0.05). Maximal exercise lowered rMSSD (3.3+/-0.08 vs. 1.2+/-0.06) and lnLF (4.1+/-0.05 vs. 3.3+/-0.13) and increased lnHF (3.3+/-0.14 vs. 4.0+/-0.10; p<0.01) from resting. However, active recovery restored lnHF (3.3+/-0.11) and lnLF (4.1+/-0.08) from maximal values (p<0.01). Our findings suggest that moderate and vigorous exercise training may enhance HRV recovery following one bout of maximal exercise in older women.